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1.
J Craniofac Surg ; 30(7): 1982-1985, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31369503

RESUMO

INTRODUCTION: Long, complex surgical procedures with non-ergonomic postures, headlights, loupe magnification, and microscope use may put craniofacial and maxillofacial surgeons at an increased risk of work-related musculoskeletal discomfort (WRMD). Identifying the prevalence and impact of WRMD may guide preventive strategies to prolong well-being, job satisfaction, and career duration. METHODS: A 31-question survey was designed to evaluate WRMD. The survey was sent to American Society of Craniofacial Surgeons and American Society of Maxillofacial Surgeons members. The survey was created and distributed electronically through a private survey research center (Qualtrics Survey Software). RESULTS: There were 95 respondents (23.75% response rate): 75% male, 56% aged 31 to 50 years old, and 73% in academic practice. On a scale of 0 to 10 (0 no pain, 10 worst pain), WRMD for surgery without loupes/microscope had a median of 3, with loupes 4, and with microscope 5. Pain was most common in the neck. Pain within 4 hours of surgery was present in 55% and 38% feared pain would influence future surgical performance. Surgeon discomfort affects posture (72%), stamina (32%), sleep (28%), surgical speed (24%), relationships (18%), and concentration (17%). Medical treatment for discomfort was sought by 22%. Time off work for treatment occurred in 9%. CONCLUSION: The WRMD can affect many aspects of a craniofacial or maxillofacial surgeon's life and has the potential to shorten or end a career. Occupational health and surgical ergonomics should be emphasized during surgical training and in surgical practice.


Assuntos
Doenças Musculoesqueléticas/etiologia , Doenças Profissionais , Cirurgiões Bucomaxilofaciais/estatística & dados numéricos , Adulto , Ergonomia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço , Postura , Prevalência , Inquéritos e Questionários , Estados Unidos
2.
J Oral Maxillofac Surg ; 76(4): 709-715, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29245001

RESUMO

PURPOSE: There is considerable controversy in the literature concerning the indications for frenectomy for treating a maxillary diastema and for timing of the procedure. The purpose of this study was to survey pediatric dentists, orthodontists, and oral and maxillofacial surgeons on their opinion of this matter to develop a consensus. MATERIALS AND METHODS: An anonymous 7-item electronic questionnaire was sent to members of the American Academy of Pediatric Dentists, the American Association of Orthodontists, and the American Association of Oral and Maxillofacial Surgeons asking about the etiology of the maxillary diastema, its diagnosis, and treatment. RESULTS: Although there was no agreement among the oral and maxillofacial surgeons for the timing of frenectomy and when the diastema should be closed, the pediatric dentists and orthodontists generally agreed that frenectomy should not be performed before the permanent canines are erupted and that the operation should follow orthodontic closure of the space. CONCLUSION: Although there was no complete consensus among the 3 groups, a logical treatment approach for the maxillary diastema is proposed.


Assuntos
Diastema/terapia , Odontólogos/estatística & dados numéricos , Diastema/etiologia , Diastema/cirurgia , Humanos , Maxila/cirurgia , Cirurgiões Bucomaxilofaciais/estatística & dados numéricos , Fechamento de Espaço Ortodôntico , Ortodontistas/estatística & dados numéricos , Odontopediatria/estatística & dados numéricos , Padrões de Prática Odontológica , Inquéritos e Questionários
3.
J Oral Maxillofac Surg ; 75(12): 2489-2496, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28886356

RESUMO

PURPOSE: There are few data available on the experience of minority surgeons in the field of oral and maxillofacial surgery (OMS). Therefore, the purpose of this study was to 1) explore factors that contribute to African Americans choosing OMS as a career, 2) examine satisfaction among minority oral and maxillofacial surgeons with the residency application and training process, 3) report on practice patterns among minority oral and maxillofacial surgeons, and 4) identify perceived bias for or against minority oral and maxillofacial surgeons in an attempt to aid the efforts of OMS residency organizations to foster diversity. MATERIALS AND METHODS: A 19-item survey was sent to 80 OMS practitioners by use of information from the mailing list of the National Society of Oral and Maxillofacial Surgeons, an American Association of Oral and Maxillofacial Surgeons-affiliated organization. All surveys were sent by mail and were followed by a reminder mailing after 8 weeks. Responses returned within 16 weeks were accepted for analysis. RESULTS: Of the 80 mailed surveys, 41 were returned within the 16-week parameter, representing a return rate of 51%. Most of the minority surgeon respondents were married men with a mean age of 60 years who worked as private practitioners. Most respondents practiced on the eastern and western coasts of the United States. Exposure in dental school was the most important factor in selecting OMS as a specialty. Location and prestige were the most important factors in selecting a residency program. Most respondents reported that race did not affect the success of their application to a residency program and did not currently affect the success of their practice. However, 25 to 46% of participants experienced race-related harassment, and 48 to 55% of participants believed there was a bias against African Americans in OMS. CONCLUSIONS: Our data suggest that a substantial number of minority oral and maxillofacial surgeons subjectively perceive race-based bias in their career, although it does not appear to affect professional success.


Assuntos
Negro ou Afro-Americano , Escolha da Profissão , Satisfação no Emprego , Cirurgiões Bucomaxilofaciais , Padrões de Prática Médica/estatística & dados numéricos , Cirurgia Bucal , Adulto , Negro ou Afro-Americano/educação , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Atitude do Pessoal de Saúde/etnologia , Feminino , Humanos , Internato e Residência/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Cirurgiões Bucomaxilofaciais/educação , Cirurgiões Bucomaxilofaciais/psicologia , Cirurgiões Bucomaxilofaciais/estatística & dados numéricos , Cirurgiões Bucomaxilofaciais/provisão & distribuição , Racismo/etnologia , Racismo/psicologia , Racismo/estatística & dados numéricos , Cirurgia Bucal/educação , Cirurgia Bucal/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos
4.
J Oral Maxillofac Surg ; 74(5): 995-1012, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26706488

RESUMO

PURPOSE: Management of zygomaticomaxillary complex (ZMC) fractures should be based on injury patterns and not on training background. This study assessed management decisions for ZMC injuries among surgeons with different training backgrounds. MATERIALS AND METHODS: This was a cross-sectional study of surgeons who evaluated 5 ZMC injury cases. The primary predictor variable was training background: plastic and reconstructive surgeons (PRSs), craniofacial PRSs (c-PRSs), and oral and maxillofacial surgeons (OMSs). Other variables were years in practice, fellowship training, practice scope, and comfort with managing facial injuries. The primary outcome variable was management of the ZMC and orbital floor (operative vs nonoperative). Secondary outcome measurements were related to surgical approaches and fixation. Descriptive, bivariate, and regression statistics were computed. RESULTS: Twenty-one surgeons (7 PRSs, 7 c-PRSs, and 7 OMSs) with an average of 14.4 ± 12.6 years of experience provided a total of 105 treatment plans. There was significant agreement between c-PRSs and OMSs for management of ZMC and orbital floor injuries (rs = 0.70 and 0.76, respectively; P ≤ .001). PRSs did not have substantial agreement with c-PRSs or OMSs with regard to ZMC fractures (rs = 0.39 and 0.49, respectively; P ≤ .06), but significant agreement with regard to orbital floor injuries (rs = 0.70 and 0.76, respectively; P < .001). In a regression model, injury pattern was the only factor associated with operative management (P ≤ .001). CONCLUSIONS: There is substantial agreement between OMSs and c-PRSs regarding the management of ZMC fractures and associated orbital floor injuries.


Assuntos
Tomada de Decisão Clínica , Cirurgiões Bucomaxilofaciais/estatística & dados numéricos , Procedimentos de Cirurgia Plástica/estatística & dados numéricos , Fraturas Zigomáticas/cirurgia , Estudos Transversais , Humanos , Padrões de Prática Médica/estatística & dados numéricos , Fraturas Zigomáticas/patologia
5.
J Oral Maxillofac Surg ; 74(4): 719-28, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26707428

RESUMO

PURPOSE: To determine the perceived utility and demand for the application of telemedicine for improved patient care between nonsurgical dental practitioners (GPs) and oral and maxillofacial surgeons (OMS). MATERIALS AND METHODS: Two distinct questionnaires were made, one for GPs and one for OMSs. The GP questionnaire was sent to practicing Virginia Dental Association members on an e-mail list (approximately 2,200). The OMS questionnaire was sent by the Virginia Society of Oral Maxillofacial Surgery to members on an e-mail list (approximately 213). Questionnaires included questions about access to care, benefits of telemedicine consultations, reliability of telemedicine consultations, and perceived barriers against and opportunities for the implementation of telemedicine. The questionnaire was completed by 226 GP and 41 OMS respondents. RESULTS: There was a significant difference among responses of GPs based on practice location: rural patients had a longer average time from referral to OMS consultation (P = .003), rural patients traveled longer distances (P < .0001), rural practitioners referred more patients (P = .0038), and rural GPs referred more single-tooth implant cases (P = .0039). GP respondents moderately agreed to statements about the benefits of telemedicine, whereas OMS respondents were more neutral. GPs responded they would refer more patients (4.4) if consultations could be performed by telemedicine. OMSs agreed that more referrals would influence their decision to provide telemedicine consultations (51%). Practitioners had neutral perceptions about the reliability of telemedicine. OMS respondents agreed they would implement telemedicine in their practice if it provided equally good consultations as in-office visits. CONCLUSION: According to the present findings, telemedicine could be an important step in the right direction for overcoming current issues with patient access to care and increasing health care costs. The benefits of telemedicine technology have been documented and will continue to be seen with wider application of its use in other areas of health care such as oral and maxillofacial surgery.


Assuntos
Odontólogos/estatística & dados numéricos , Odontologia Geral , Cirurgiões Bucomaxilofaciais/estatística & dados numéricos , Telemedicina/estatística & dados numéricos , Atitude do Pessoal de Saúde , Implantes Dentários para Um Único Dente , Odontólogos/psicologia , Acessibilidade aos Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Relações Interprofissionais , Cirurgiões Bucomaxilofaciais/psicologia , Satisfação Pessoal , Área de Atuação Profissional , Encaminhamento e Consulta/estatística & dados numéricos , Consulta Remota/estatística & dados numéricos , População Rural , População Suburbana , Telemedicina/normas , Fatores de Tempo , População Urbana
6.
J Oral Maxillofac Surg ; 73(12): 2440-5, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26341681

RESUMO

PURPOSE: The purpose of this study was to assess the participation of Canadian oral and maxillofacial surgeons (OMSs) in the various phases of oral, lip, and oropharyngeal cancer care. MATERIALS AND METHODS: A survey was conducted to quantify participation in oral, lip, and oropharyngeal cancer care and assess participation ranging from screening for malignancy to active treatment and rehabilitation of those with late-stage disease. RESULTS: Three hundred ninety-one surgeons were contacted and 206 (52.7%) responded to the online survey. The survey showed 98.1% of respondents were involved with cancer screening and 97.1% were involved in prevention and early intervention (monitoring and treatment) of premalignant lesions. In addition, 95.1% of respondents participated in diagnosis and staging of tumors. Early-stage cancer was managed surgically by 49.5% of respondents, whereas 11.2% of respondents managed late-stage disease. Management of oral rehabilitation was performed by 79.0% of respondents. CONCLUSION: OMSs are an integral part of all phases of oral and oropharyngeal cancer care, including primary surgical oncology, in Canada. Although OMSs in Canada participate widely in integral prevention and survivor rehabilitation programs, few members participate in late-stage disease management and regional multidisciplinary care teams.


Assuntos
Neoplasias Labiais/cirurgia , Neoplasias Bucais/cirurgia , Cirurgiões Bucomaxilofaciais/estatística & dados numéricos , Neoplasias Orofaríngeas/cirurgia , Canadá , Dibenzocicloeptenos , Humanos , Neoplasias Labiais/diagnóstico , Neoplasias Labiais/terapia , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/terapia , Neoplasias Orofaríngeas/diagnóstico , Neoplasias Orofaríngeas/terapia , Papel do Médico , Padrões de Prática Médica/estatística & dados numéricos
7.
Implant Dent ; 24(5): 517-26, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26035375

RESUMO

AIMS: To assess the learning curve of a minimally invasive procedure for maxillary sinus floor elevation with a transcrestal approach (tSFE) and evaluate the influence of clinician's experience in implant surgery on its outcomes. MATERIALS AND METHODS: Patients were treated by clinicians with different levels of experience in implant surgery and inexperienced with respect to the investigated tSFE technique. The initial (n = 13) and final (n = 13) groups treated by the expert clinician were compared for tSFE outcomes. Additionally, the high, moderate, and low groups (n = 20 each) treated by the expert, moderately experienced, and low experienced clinician, respectively, were compared. RESULTS: (1) No significant differences in clinical and radiographic outcomes were observed between initial and final groups; (2) high, moderate, and low groups showed substantial vertical augmentation in limited operation time with treatment outcomes being influenced by the level of experience in implant surgery. CONCLUSIONS: The investigated technique allows for a substantial vertical augmentation at limited operation times when used by different clinicians. The extent of sinus lift (as radiographically assessed) seems to be influenced by the clinician's level of experience in implant dentistry.


Assuntos
Procedimentos Cirúrgicos Minimamente Invasivos/educação , Levantamento do Assoalho do Seio Maxilar/métodos , Competência Clínica , Implantação Dentária/educação , Implantação Dentária/métodos , Feminino , Humanos , Curva de Aprendizado , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Cirurgiões Bucomaxilofaciais/educação , Cirurgiões Bucomaxilofaciais/normas , Cirurgiões Bucomaxilofaciais/estatística & dados numéricos , Estudos Prospectivos , Radiografia Dentária
8.
J Craniomaxillofac Surg ; 52(5): 565-569, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38368211

RESUMO

The aim of this bibliometric analysis was to benchmark the publication activities of German university departments of oral and maxillofacial surgery. The publication performance of staff surgeons (chief and consultants), documented by first or last authorship, from 37 German university departments was captured over a 10-year period (January 1, 2010, to December 31, 2019). All publications listed in PubMed were included. Additionally, the Impact Factor (IF) was determined. A total of 213 surgeons were identified, of whom 158 (74.2%) were publishing. The number of publications was 1,777, published in 311 journals. Publication activity ranged from an average of 23.3 publications per staff surgeon in the top-ranked department to 0 publications in the last-ranked. The same trend was observed for the total cumulative IFs (CIFs) per member (range from 56.2 to 0). The most common used journal was the Journal of Cranio-Maxillofacial Surgery (19.7%), with focus on "dentoalveolar surgery" (24%) and "operative techniques and procedures" (28.3%). Women constituted 19.2% of the staff, contributing to 8.5% of the publications. The publication performance of German university departments of oral and maxillofacial surgery exhibits a high variance, which did not correlate with the number of personnel and could only be explained by different research motivations.


Assuntos
Bibliometria , Editoração , Alemanha , Humanos , Editoração/estatística & dados numéricos , Cirurgiões Bucomaxilofaciais/estatística & dados numéricos , Feminino , Masculino , Cirurgia Bucal/estatística & dados numéricos , Universidades , Fator de Impacto de Revistas
9.
J Stomatol Oral Maxillofac Surg ; 125(4): 101753, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38147956

RESUMO

INTRODUCTION: Online reputation is misattributed in France in academic publications. However, this phenomenon is growing. The objective of this study was to establish an inventory of the e-reputation of French maxillofacial surgeons through the opinions posted on their professional Google® account. MATERIAL AND METHODS: A descriptive study included all the surgeons registered on the list of the French National Medical Council in "maxillofacial surgery and stomatology". Data collection was carried out from February to April 2022. RESULTS: Among the 483 surgeons included, 61.1% had received at least one opinion, the number of per surgeon was 22.2. The average was 4.3/5. Among the 4433 written comments completing the review, 85% were positive. The average response rate of surgeons was 10% and was all the more important as the rating of the opinion was lower. Stomatology (65.3%), aesthetic surgery of the face (15.1%) and orthognathic surgery (14.5%) were the most commented maxillofacial procedures. DISCUSSION: The online image of French maxillofacial surgeons was very positive. However, faced with a defamatory or insulting comment, the surgeon found in an unbalanced situation where he could not respond without risking betraying medical. We recall some common-sense recommendations for managing one's e-reputation and some legislative adjustments for better regulation of these platforms, also considering legal and ethical aspects.


Assuntos
Cirurgiões Bucomaxilofaciais , França , Humanos , Cirurgiões Bucomaxilofaciais/estatística & dados numéricos , Cirurgiões Bucomaxilofaciais/psicologia , Cirurgiões Bucomaxilofaciais/organização & administração , Comunicação , Internet/estatística & dados numéricos , Atitude do Pessoal de Saúde , Cirurgia Bucal/estatística & dados numéricos , Cirurgia Bucal/organização & administração , Cirurgia Bucal/normas , Masculino
10.
J Stomatol Oral Maxillofac Surg ; 125(5S2): 101979, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39068990

RESUMO

OBJECTIVE: This study aims to evaluate the capacity of ChatGPT-4o to generate new systematic review ideas in the field of oral and maxillofacial surgery. The data obtained from this study will provide evidence-based information to oral and maxillofacial surgeons regarding the academic use of GPT-4o. MATERIALS AND METHODS: ChatGPT-4o was asked to provide four previously unpublished systematic review ideas each for the topics of impacted third molars, dental implants, orthognathic surgery, and temporomandibular disorders. A literature search was conducted in the PubMed database to check if the ideas generated by GPT-4o had been previously published, and the search results were compared with the ideas generated by the AI. RESULTS: The PubMed database search resulted in a total of 871 publications, with 37 publications found to be related to the topics generated by GPT-4o after the first and second screening. Out of the 16 publication ideas generated by GPT-4o, 9 (56.25 %) were determined to be previously unexplored according to the PubMed database search. There was no statistically significant relationship between the presence of ChatGPT's suggestions in PubMed and the subject areas of the studies. CONCLUSION: ChatGPT-4o has a high potential to be used as a valuable tool for suggesting systematic review topics in oral and maxillofacial surgery. Additionally, this tool can assist researchers not only in proposing publication ideas but also in developing the methodology of the study.


Assuntos
Dente Serotino , Humanos , Dente Serotino/cirurgia , Dente Serotino/fisiologia , Revisões Sistemáticas como Assunto/métodos , Dente Impactado/cirurgia , Dente Impactado/diagnóstico , Transtornos da Articulação Temporomandibular/diagnóstico , Implantes Dentários/normas , Cirurgia Bucal/métodos , Cirurgiões Bucomaxilofaciais/psicologia , Cirurgiões Bucomaxilofaciais/estatística & dados numéricos , Procedimentos Cirúrgicos Ortognáticos/métodos
12.
N Z Med J ; 133(1513): 11-22, 2020 04 24.
Artigo em Inglês | MEDLINE | ID: mdl-32325464

RESUMO

AIM: To describe and consider the findings of a workforce survey of New Zealand Oral and Maxillofacial Surgeons (OMS) which was conducted in 2017-18, and to compare those to findings from a similar survey undertaken in 2001. METHODS: A questionnaire was used to obtain information on the qualifications, sociodemographic characteristics and and practising circumstances of all practising OMS in New Zealand. Data were analysed using SPSS (version 24). After the computation of descriptive statistics, cross-tabulations were used to identify differences in proportions (with those tested for statistical significance using Chi-squared tests), and analysis of variance was used to examine differences in means. RESULTS: All 39 OMS took part. There were 17 medically qualified surgeons who also held a surgical fellowship, comprising just under half of the workforce. Overall, one in eight surgeons worked solely in the public sector, while just under one-quarter worked solely in private; the remainder worked in both sectors. Dentoalveolar procedures were by far the most common undertaken (with considerably more done by older surgeons than younger ones), followed by implants, the treatment of facial trauma, skin lesions and surgery for malignancy. Orthognathic surgery and dentoalveolar trauma procedures were the least commonly reported. Only two-thirds of surgeons participated in public on-call work. While 95% of surgeons were indeed satisfied with their work, the lowest rate was observed among those working solely in the public sector, where it was 80%; among those working exclusively in private, it was 100%. Between 2001 and 2017-18, the proportion of medically qualified surgeons rose from just over one-quarter to more than two-thirds. The proportion of surgeons working solely in private practice rose from one in seven to almost one-quarter. There were marked increases in the mean number of malignancies dealt with and implants provided. CONCLUSION: The findings highlight a number of problems-some long-standing, others emerging-in New Zealand's OMS system. Fewer surgeons are participating in public sector provision and there is stress on those who remain. Workforce planners should be aware that more resources need to be put into training surgeons who will take up hospital appointments and provide essential after-hours emergency services.


Assuntos
Cirurgiões Bucomaxilofaciais , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , Cirurgiões Bucomaxilofaciais/organização & administração , Cirurgiões Bucomaxilofaciais/estatística & dados numéricos , Prática Privada/estatística & dados numéricos , Setor Público/estatística & dados numéricos , Inquéritos e Questionários , Recursos Humanos
14.
Epidemiol Serv Saude ; 28(1): e2018351, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30970077

RESUMO

OBJECTIVE: to analyze the availability of public specialized dental care services at Dental Specialties Centers (CEO) in Brazil in 2014. METHODS: secondary data on the CEO ratio and dental surgeon ratio were analyzed by population as well as the adequacy of the quantity of complete dental consulting rooms per CEO type, the adequacy of the ratio between the working hours of dental auxiliaries /technicians and those of dental surgeons and the adequacy of the availability of recommended minimum specialties. Possible statistical differences between macro-regions were verified. RESULTS: we found a ratio of one CEO per 217,797 inhabitants and one dental surgeon per 26,811 inhabitants; 97% of CEOs had the recommended number of dental consulting rooms; 26% had equivalent working hours between dental auxiliaries /technicians and dental surgeons; 60% offered the recommended minimum specialties. CONCLUSION: there were limitations in the provision of National Health System specialized oral health care services as well as regional differences.


Assuntos
Assistência Odontológica/estatística & dados numéricos , Serviços de Saúde Bucal/provisão & distribuição , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Programas Nacionais de Saúde/estatística & dados numéricos , Brasil , Serviços de Saúde Bucal/estatística & dados numéricos , Odontólogos/estatística & dados numéricos , Odontólogos/provisão & distribuição , Humanos , Programas Nacionais de Saúde/organização & administração , Cirurgiões Bucomaxilofaciais/estatística & dados numéricos , Cirurgiões Bucomaxilofaciais/provisão & distribuição , Especialidades Odontológicas/estatística & dados numéricos
15.
JMIR Mhealth Uhealth ; 7(3): e11251, 2019 03 07.
Artigo em Inglês | MEDLINE | ID: mdl-30843867

RESUMO

BACKGROUND: The surgical microscope is used primarily for microsurgeries, which are more complicated than other surgical procedures and require delicate tasks for a long time. Therefore, during these surgical procedures, surgeons experience back and neck pain. To solve this problem, new technology, such as wearable displays, is required to help surgeons maintain comfortable postures and enjoy advanced functionality during microsurgery. OBJECTIVE: The objective of this study was to develop a surgical microscope system that would work with wearable devices. It would include a head-mounted display (HMD) that can offer 3D surgical images and allow a flexible and comfortable posture instead of fixed eyepieces of surgical microscope and can also provide peripheral visual field with its optical see-through function. METHODS: We designed and fabricated a surgical microscope system that incorporates a see-through type 3D HMD, and we developed an image processing software to provide better image quality. The usability of the proposed system was confirmed with preclinical examination. Seven ENT (ear, nose, and throat) surgical specialists and 8 residents performed a mock surgery-axillary lymph node dissection on a rat. They alternated between looking through the eyepieces of the surgical microscope and viewing a 3D HMD screen connected to the surgical microscope. We examined the success of the surgery and asked the specialists and residents to grade eye fatigue on a scale of 0 (none) to 6 (severe) and posture discomfort on a scale of 1 (none) to 5 (severe). Furthermore, a statistical comparison was performed using 2-tailed paired t test, and P=.00083 was considered significant. RESULTS: Although 3D HMD case showed a slightly better result regarding visual discomfort (P=.097), the average eye fatigue was not significantly different between eyepiece and 3D HMD cases (P=.79). However, the average posture discomfort, especially in neck and shoulder, was lower with 3D HMD display use than with eyepiece use (P=.00083). CONCLUSIONS: We developed a see-through type 3D HMD-based surgical microscope system and showed through preclinical testing that the system could help reduce posture discomfort. The proposed system, with its advanced functions, could be a promising new technique for microsurgery.


Assuntos
Microscopia/instrumentação , Microcirurgia/instrumentação , Cirurgiões Bucomaxilofaciais/psicologia , Dispositivos Eletrônicos Vestíveis/normas , Adulto , Animais , Astenopia/etiologia , Astenopia/prevenção & controle , Modelos Animais de Doenças , Estudos de Viabilidade , Humanos , Imageamento Tridimensional/instrumentação , Imageamento Tridimensional/métodos , Imageamento Tridimensional/normas , Masculino , Microscopia/normas , Microscopia/estatística & dados numéricos , Microcirurgia/métodos , Cirurgiões Bucomaxilofaciais/estatística & dados numéricos , Ratos , Óculos Inteligentes/normas , Óculos Inteligentes/estatística & dados numéricos , Instrumentos Cirúrgicos/normas , Instrumentos Cirúrgicos/estatística & dados numéricos , Dispositivos Eletrônicos Vestíveis/psicologia , Dispositivos Eletrônicos Vestíveis/estatística & dados numéricos
16.
Epidemiol Serv Saude ; 27(1): e201723615, 2018 03 05.
Artigo em Inglês, Português | MEDLINE | ID: mdl-29513857

RESUMO

OBJECTIVE: the objective was to analyze trends in the dental surgeon workforce in Brazil between 2007 and 2014. METHODS: this is a time series study using data from the Brazilian National Register of Health Establishments and the Brazilian National Institute of Geography and Statistics. Prais-Winsten generalized linear regression was used to estimate time trends and to calculate the annual percent change in the dental surgeon workforce over the period. RESULTS: the number of dental surgeons working as general practitioners and as specialists grew on average by 12.7% and 17.3% per annum, respectively; dental surgeon workforce expansion in relation to general practitioners (0.5%) and specialists (11.6%) was lower in the public sector, compared to the private sector (24.5% and 30.3%, respectively). CONCLUSION: the number of dental surgeons in Brazil is high, although they are not equally distributed between both sectors. This may imply barriers to dental care access in Brazil.


Assuntos
Cirurgiões Bucomaxilofaciais/estatística & dados numéricos , Setor Privado/estatística & dados numéricos , Setor Público/estatística & dados numéricos , Recursos Humanos/tendências , Brasil , Acessibilidade aos Serviços de Saúde , Humanos , Modelos Lineares , Cirurgiões Bucomaxilofaciais/organização & administração , Cirurgiões Bucomaxilofaciais/provisão & distribuição , Sistema de Registros , Fatores de Tempo
17.
J Endod ; 44(2): 226-232, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29254814

RESUMO

INTRODUCTION: The aim of this study was to investigate changes in treatment planning decisions among different practitioner groups over 7 years for teeth with apical periodontitis and a history of endodontic treatment. METHODS: A Web-based survey was sent to dentists in Pennsylvania in 2009 consisting of 14 cases with nonhealing periapical lesions and intact restorations without evidence of recurrent caries. Participants selected among 5 treatment options: wait and observe, nonsurgical retreatment (NSRTX), surgical retreatment (SRTX), extraction and fixed partial denture, or extraction and implant (EXIMP). In 2016, the identical survey was resent to the original 2009 participants. RESULTS: In 2009, 262 dentists participated in the survey. Two hundred one participants were general practitioners (GPs: 76.7%), 26 endodontists (ENDOs: 9.9%), and 35 other specialists (prosthodontics, periodontics, and oral surgery [SPECs]: 13.4%) (n = 262). EXIMP, NSRTX, and SRTX were fairly equally selected but with great variation between practitioner groups (χ2 = 173.49, P < .05). A subset group of 104 participants (SUB) (39.7% of the original participants) retook the survey in 2016 (69 GPs [66.3%], 15 ENDOs [14.0%], and 20 SPECs [19.7%]). Comparisons among practitioner groups were significantly different in SUB (n = 104) for 2009 (χ2 = 95.536, P < .05) and 2016 (χ2 = 109.8889, P < .05). Intragroup reliability between 2009 and 2016 revealed no significant differences between the overall treatment planning choices for all practitioners (GPs, ENDOs, or SPECs). Intrapractitioner reliability showed many treatment planning decision changes on an individual level. Chances that individuals changed their original decision were 47.8% (95% confidence interval, 45.2%-50.4%) and were significantly different among the 3 practitioner groups (GPs > SPECs > ENDOs [χ2 = 11.2792, P < .05]). No significant changes were observed in the decision for tooth saving versus replacement treatment options (P = .520). CONCLUSIONS: No significant differences were noted between current and past treatment planning decisions in regard to tooth preservation by endodontic retreatment versus tooth extraction and replacement. However, individual practitioners lacked consistency in their decision making over time.


Assuntos
Periodontite Periapical/terapia , Tratamento do Canal Radicular/efeitos adversos , Especialidades Odontológicas , Dente não Vital/terapia , Adulto , Tomada de Decisões , Odontólogos/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cirurgiões Bucomaxilofaciais/estatística & dados numéricos , Ortodontistas/estatística & dados numéricos , Especialidades Odontológicas/métodos , Especialidades Odontológicas/estatística & dados numéricos , Inquéritos e Questionários
18.
Br J Oral Maxillofac Surg ; 55(1): 17-21, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27633904

RESUMO

Most of the decisions made in planning treatment with implants rely on the clinician's assessment of the density of the jawbone. However, we know of only a few studies that have evaluated the clinicians' subjectivity and the objective quantitative methods. Our aim was to assess whether the characteristics of the bone seen on preoperative imaging are similar to the features faced during the operation. We collected data about 32 implant procedures done during the Specialisation Course for Implant Dentistry, Universidade de Ribeirão Preto, San Paulo. First, the clinicians evaluated the panoramic radiograph and computed tomographic scans preoperatively, classified the bone density according to the Lekholm and Zarb classification, and marked their subjective evaluation on a visual analogue scale. Postoperatively the surgeons filled out a questionnaire based on their subjective perceptions obtained during the insertion of the implants. Another examiner answered the same questionnaire after looking at the patient's images but without knowing the surgeon's results. There was a good correlation between the surgeons' preoperative classification of the type of bone and their tactile perception (p=0.000), and a good correlation between the surgeon's preoperative classification of the bone and the examiner's findings (p=0.000). We conclude that imaging is an important part of preoperative planning and can predict the quality of the bone when coupled with the opinion of a trained clinician, objective analysis, and standard classification of the bone.


Assuntos
Processo Alveolar/diagnóstico por imagem , Implantação Dentária Endóssea/métodos , Planejamento de Assistência ao Paciente , Radiografia Dentária , Percepção do Tato , Processo Alveolar/patologia , Processo Alveolar/cirurgia , Densidade Óssea , Humanos , Cirurgiões Bucomaxilofaciais/estatística & dados numéricos , Radiografia Dentária/métodos , Radiografia Panorâmica , Inquéritos e Questionários , Tomografia Computadorizada por Raios X
19.
J Endod ; 43(2): 194-199, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28132707

RESUMO

INTRODUCTION: Clinical information and diagnostic imaging are essential components of preoperative diagnosis. The aim of this study was to determine the influence of cone-beam computed tomographic (CBCT) imaging on clinical decision-making choices among different specialists (prosthodontists, endodontists, oral surgeons, and periodontists) in endodontic treatment planning. A secondary objective was to assess the self-reported level of difficulty in making a treatment choice before and after viewing a preoperative CBCT scan. METHODS: In accordance with the endodontic case difficulty guidelines of the American Association of Endodontists, 30 endodontic cases with varying degrees of complexity were selected. Each case included clinical photographs, digital periapical radiographs, and a small-volume CBCT scan. In the first evaluation, examiners were given all the information of each case, except the CBCT scan. Examiners were asked to select one of the proposed treatment alternatives and assess the difficulty of making a decision. One month later, the examiners reviewed randomly the same 30 cases with the additional information from the CBCT data. RESULTS: The CBCT scans only had a significant influence on the treatment plan when the endodontic case was classified as high difficulty (P < .05). The level of difficulty in choosing a treatment choice was significantly more difficult after viewing a preoperative CBCT scan (P < .05), with the exception of the endodontists (P = .033). After viewing the CBCT scan, the extraction option increased significantly (P < .05). CONCLUSIONS: CBCT imaging has a substantial impact on endodontic decision making among specialists, particularly in high difficulty cases.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Padrões de Prática Odontológica/estatística & dados numéricos , Tomada de Decisão Clínica , Odontólogos/estatística & dados numéricos , Endodontistas/estatística & dados numéricos , Feminino , Humanos , Masculino , Cirurgiões Bucomaxilofaciais/estatística & dados numéricos , Tratamento do Canal Radicular/estatística & dados numéricos , Doenças Dentárias/diagnóstico por imagem , Doenças Dentárias/terapia , Raiz Dentária/diagnóstico por imagem
20.
J Dent Educ ; 81(1): 75-86, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28049680

RESUMO

The aims of this study were to determine whether male vs. female oral and maxillofacial surgery (OMS) residents, academic surgeons (i.e., faculty members), and private practitioners in the U.S. differed in their general career satisfaction and job/professional satisfaction. Survey data were collected in 2011-12 from 267 OMS residents (response rate 55%), 271 OMS academic surgeons (response rate 31%), and 417 OMS private practitioners (response rates 13% web-based survey and 29% postal mail survey). The results showed that while the male vs. female OMS private practitioners and academic surgeons did not differ in their career satisfaction, the female residents had a lower career satisfaction than the male residents (on four-point scale with 4=most satisfied: 3.03 vs. 3.65; p<0.01). The male vs. female OMS private practitioners and academic surgeons also did not differ in their job satisfaction. However, the female residents agreed on average less that they were able to practice OMS in the way they want, felt less proud to be an oral and maxillofacial surgeon, were less satisfied with their career, and were more likely to consider a career change in the next five years than the male residents. While these male and female oral and maxillofacial surgeons in private practice and academia did not differ in their career and job satisfaction, the male and female residents differed significantly, with female residents reporting a significantly poorer career and job satisfaction than male residents. Future research needs to explore ways to improve career and professional satisfaction of female OMS residents.


Assuntos
Docentes de Odontologia/psicologia , Internato e Residência , Satisfação no Emprego , Cirurgiões Bucomaxilofaciais/psicologia , Prática Privada , Adulto , Docentes de Odontologia/estatística & dados numéricos , Feminino , Humanos , Internato e Residência/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Cirurgiões Bucomaxilofaciais/estatística & dados numéricos , Prática Privada/estatística & dados numéricos , Fatores Sexuais , Inquéritos e Questionários , Estados Unidos
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